The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration.
The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration.
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DOI：
10.1016/j.biomaterials.2011.06.037
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发表时间：
2011-10
期刊：
影响因子：
14
通讯作者：
Athanasiou, Kyriacos A.
中科院分区：
文献类型：
--
作者：
Makris, Eleftherios A.;Hadidi, Pasha;Athanasiou, Kyriacos A.
近几十年来，广泛的科学研究已经确定了半月板在膝关节内的解剖学，生物力学和功能重要性。作为关节的重要组成部分，它可以防止关节软骨的退化和退化，以及骨关节炎的发生和发展。出于这个原因，半月板修复的研究一直是骨科和生物工程界特别感兴趣的对象。目前的修复技术仅对治疗半月板周围血管化区域的病变有效。在高度苛刻的机械环境下发挥功能的内无血管区中发现的愈合病变被认为是一个重大挑战。尽管已经进行了许多尝试，但还没有建立适当的治疗方法。目前的主要治疗方法是部分骨关节炎切除术，这通常会导致骨关节炎的进行性发展。这一缺点使研究兴趣转向生物材料和生物工程领域，人们希望在组织工程的帮助下解决组织退化问题。到目前为止，不同的方法和策略有助于半月板结构的体外生成，其能够在一定程度上恢复半月板损伤，无论是功能上还是解剖学上。选择合适的细胞来源（自体、同种异体或异种细胞，或干细胞）无疑被认为是成功的组织工程的关键。此外，在实验和临床研究中已经提出并产生了用于组织工程的大量变化的支架，尽管这些支架存在一些问题（例如，降解的副产物，应力屏蔽）已经将研究兴趣转向新的策略（例如，无支架方法、自组装）。大量不同的化学品（例如，TGF-β1，C-ABC）和机械刺激（例如，直接压缩、静水压力）在促进功能性组织形成以及分化干细胞方面也进行了研究。尽管伴随半月板组织工程研究的问题是相当大的，我们无疑是在一个新时代的曙光，其中生物学，工程学和医学的最新进展导致成功治疗半月板病变。
Extensive scientific investigations in recent decades have established the anatomical, biomechanical, and functional importance that the meniscus holds within the knee joint. As a vital part of the joint, it acts to prevent the deterioration and degeneration of articular cartilage, and the onset and development of osteoarthritis. For this reason, research into meniscus repair has been the recipient of particular interest from the orthopedic and bioengineering communities. Current repair techniques are only effective in treating lesions located in the peripheral vascularized region of the meniscus. Healing lesions found in the inner avascular region, which functions under a highly demanding mechanical environment, is considered to be a significant challenge. An adequate treatment approach has yet to be established, though many attempts have been undertaken. The current primary method for treatment is partial meniscectomy, which commonly results in the progressive development of osteoarthritis. This drawback has shifted research interest towards the fields of biomaterials and bioengineering, where it is hoped that meniscal deterioration can be tackled with the help of tissue engineering. So far, different approaches and strategies have contributed to the in vitro generation of meniscus constructs, which are capable of restoring meniscal lesions to some extent, both functionally as well as anatomically. The selection of the appropriate cell source (autologous, allogeneic, or xenogeneic cells, or stem cells) is undoubtedly regarded as key to successful meniscal tissue engineering. Furthermore, a large variation of scaffolds for tissue engineering have been proposed and produced in experimental and clinical studies, although a few problems with these (e.g., byproducts of degradation, stress shielding) have shifted research interest towards new strategies (e.g., scaffoldless approaches, self-assembly). A large number of different chemical (e.g., TGF-β1, C-ABC) and mechanical stimuli (e.g., direct compression, hydrostatic pressure) have also been investigated, both in terms of encouraging functional tissue formation, as well as in differentiating stem cells. Even though the problems accompanying meniscus tissue engineering research are considerable, we are undoubtedly in the dawn of a new era, whereby recent advances in biology, engineering, and medicine are leading to the successful treatment of meniscal lesions.
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影响因子：
4.7
作者：
Barrett, GR;Field, MH;Ruff, CG
通讯作者：
Ruff, CG
DOI：
10.1115/1.3138409
发表时间：
1983-01-01
影响因子：
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作者：
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通讯作者：
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作者：
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通讯作者：
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DOI：
10.2106/00004623-200307000-00011
发表时间：
2003-07-01
影响因子：
5.3
作者：
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通讯作者：
Anderson, AF